New Lots, Lots of Fun

Managing supplies is complex. Contracts, par levels, shipping schedules, and storage issues are unique in a hospital setting, because the laboratory is largely self-contained. Your central warehouse may distribute gloves, sharps containers, and other common items, but chemistry reagents are yours to manage, for example. Added to this complexity is lot sequestration.

I’ve been pondering this as we approach switching coagulation reagent lots. Every year we dread this lot changeover. (Are we the only ones?)

Depending on the manufacturer and reagent system used, there can be significant drift in normal ranges that affect INR calculations and heparin sensitivity that affects therapeutic ranges and heparin protocols. A lot to lot change in coagulation is more complex than with other methods for these reasons, involving collecting at least 40 “normal” patients, performing a correlation between old and new lots, testing quality control, and possibly creating a new heparin curve. Ideally, this should involve multiple shifts and techs to simulate real use over time to include as many variables as possible.

It can be confusing, expensive, time-consuming, and frustrating. What a pain.

Maybe, your lab has found a way to make it painless. I’d love to hear about it. In the meantime, there are a few ideas that can make it easier:

Normal countdown. We post a countdown number to track how many normals we’ve collected to get phlebotomists involved. There’s something about posting a number that works.

Cholesterol testing. We offer a concurrent cholesterol test for employees who donate a normal sample for testing. This also gives us a chance to explain to people in the hospital what we’re doing and why it’s important.

Calculations. I enter the data into spreadsheet templates and share the data often with the techs to give a real time sense of where we’re at in the process. This helps some techs see there’s an end in sight.

It’s just more to do heaped atop the daily workload. Perhaps, this is harder in smaller labs with more generalists where it’s a grind switching gears day to day. It’s rarely lots of fun.